Upon entering the hospital, I noticed it was the same as outside — eerily quiet. I headed back to the ED, which was in full combat mode. Victims were arriving en masse, the trauma room was filling quickly, patients were being triaged based on the severity of their injuries and some were being taken to the operating room. It was controlled chaos at its best, but an overwhelming site to behold.

I then went quickly to the administrative suite where incident command was being established. Things were under control there so I made my way up to the operating rooms. The charge nurse at the desk was extremely busy booking cases and trying to get as much patient information as possible. Most of the victims did not have identification. Patients already were being wheeled up to the front desk. She had no time to call in staff. I started going down the list trying to reach any team members who would answer their phone and let them know this was not a drill, we urgently needed them at work. The leadership teams started arriving in short order and took over the job of calling staff. I went back to the admin suite to participate in incident command. My role as corporate operations chief for the system was now ready to begin.

The first victim was brought to the operating room at 2:44 am. By 4:00 am, we had 5 operating rooms actively running. Our goal was to get the most critical patients in the operating room as soon as possible, then find a way to do the rest of the cases that could not wait until Monday. By communicating with our nearby sister hospitals, Winnie Palmer Hospital for Women & Babies and Arnold Palmer Hospital for Children, we were able to get surgeons, PACU nurses and sterile processing personal to add to the team members who were on their way. At the busiest point in the day, we had 8 operating rooms running and 11 surgeons performing cases. By the end of the day, we had operated on 42 patients. We treated every Pulse victim who needed emergent surgery as well as the scheduled cases for that day.